Ky. children 10-17 have nation's 2nd highest obesity rate, 19.6%; adult rate of 37.7% is 9th highest, a slight improvement from 2021

Map from Trust for America's Health State of Obesity report

Kentucky Health News graph from state data

By Melissa Patrick

Kentucky Health News

Kentucky ties with Wisconsin for the nation's ninth-highest adult obesity rate, an improvement from second-highest last year, but Kentucky children aged 10-17 still have one of the nation's highest rates, No. 2, after ranking first last year.

The 20th annual State of Obesity report from Trust for America's Health says 37.7% of Kentucky adults are obese and nearly 72% of the state's adults are either obese or overweight, tied for sixth place with Delaware. Among the state's high-school students, 19.6% of them are obese and 16.2% are overweight.

Nationally, the report says the number of obese adults continues to rise, noting that 22 states had an 2022 adult obesity rate at or above 35%, up from 19 states in 2021. A a decade ago no state had an adult obesity rate at or above 35%, the report says.

"Since TFAH’s initial report, published in 2004, the national adult obesity rate has increased by 37 percent and the national youth obesity rate increased by 42 percent," says the report. 

The national adult obesity rate is 42% and the national rate for children ages 2 to 19 is nearly 20%, according to the report.  

The good news is that from 2021 to 2022, Kentucky's adult obesity rate declined 6.4%, or 2.6 percentage points, to 37.7% from 40.3%. But that was still above the levels of 2018, 2019 and 2020.

West Virginia (41%), Louisiana (40.1%), Oklahoma (40.0%), and Mississippi (39.5%) have the highest rates of adult obesity. The District of Columbia (24.3%), Colorado (25.0%), and Hawaii (25.9%) have the lowest adult obesity rates.

“It’s critical to recognize that obesity is a multifactored disease involving much more than individual behavior,” Dr. J. Nadine Gracia, president and CEO of Trust for America's Health, said in a news release. “In order to stem the decades-long trend of increasing obesity rates we have to acknowledge that the obesity crisis is rooted in economic, health, and environmental inequities. Ensuring all people and communities have equitable opportunity and access to healthy food and physical activity is fundamental to addressing this crisis.”

Kentucky continues to struggle with all of these conditions. It ranks fifth worst for the percentage of adults with diabetes (15%) and hypertension (40.3%), and nearly 27% of its adults are physically inactive, ninth worst. 

The report shows that more adult men than adult women are obese in Kentucky: 38.7% of men and 36.7% of women, a switch from last year's report. Kentucky's adult men have the second highest obesity rate in the nation; its women rank 18th, tied with Texas.

By age, Kentucky adults between 45 and 64 have the highest obesity rate, 42%. That's followed by those 25-44 (41.2%), 65 and older (33.7%) and 18 to 24 (24.1%). 

"Solving the nation’s obesity crisis will require addressing the economic and structural factors that impact where people live and their access to employment, transportation, healthcare, affordable and healthy food, and places to be physically active," says the report, which includes policy steps to address the crisis that they say should be taken by federal, state and local officials and stakeholders. They include: 

• Fully fund the Centers for Disease Control and Prevention's proven chronic disease and obesity prevention programs so they reach every state.
• Make healthy school meals available for all students and increase access to Supplemental Nutrition Assistance Program (SNAP) and other nutrition support programs.
• Implement a mandatory front-of-package labeling system on food packaging to help consumers make informed choices.
• Close tax loopholes and eliminate business-cost deductions for advertising unhealthy food to children.
• Make physical activity and the built environment safer and more accessible for everyone, including by increasing federal education funding for health and physical education and investing in active transportation projects like pedestrian and bike paths.

Providing healthier food for students can require new equipment

Jefferson County Public Schools photo

Almost all Kentucky schools are serving meals that meet federal "standards for strong nutrition, but in order to do this, many of these same schools have to work around equipment and infrastructure challenges," Ashlie Stevens reports for WEKU-FM. A survey by the Pew Charitable Trusts found that 89 percent of the state's school districts "needed at least one piece of new equipment to better serve nutritious foods."

The average cost of that is about $50,000 per school, "which is tough considering how public school cafeterias are funded," Stevens reports. Dan Ellnor, manager of the Nutrition Service Center for Jefferson County Public Schools, told her, “No local tax dollars go to feed kids; it is a completely federal grant program. . . . If we don’t make money, we can’t reinvest in the program.”

The U.S. Department of Agriculture, which oversees the school-meals program, has grant fund to help schools buy equipment, but it is relatively small "because the need across the country is so immense," Stevens reports. Legislation in Congress would expend the program to include loans.

In Jefferson County, “Our main challenge has been refrigeration with the increased fruits and vegetables,” which require "a lot more storage space," Ellnor said. Stevens adds, "The schools also need new combination ovens to roast and steam instead of fry these foods, and sometimes they just need more physical space for food prep."

USDA nixes further reduction of salt in school lunches

The U.S. Department of Agriculture announced Nov. 29 that it's halting an Obama-era plan to gradually reduce the amount of salt in school lunches each year. But the new plan would keep current sodium level targets unchanged through 2019. "Those targets are currently not more than 1,230 milligrams per meal for elementary, 1,360 mg for middle and 1,420 mg for high schools," Maria Danilova reports for The Associated Press.

The targets cover only meals served to students at breakfast and lunch, not a la carte items sold during meal times or vending machines and other sources of non-meal food sales. Public schools nationwide require that all such non-meal foods meet the nutritional requirements of the USDA's Smart Snacks Standard, first implemented in 2014. Those standards require that snacks be lower in sodium.

Margo Wootan of the Center for Science in the Public Interest said current sodium levels are too high, and the high-school sodium target is two-thirds of a child's daily recommended intake. "This is locking in dangerously high levels of salt in school meals," she told Danilova. The federal Centers for Disease Control and Prevention backs up this claim, saying that about 90 percent of school-age U.S. children eat too much sodium daily, and that 1 in 6 children have raised blood pressure (which can be lowered partly with a healthy diet that includes less sodium).

In Kentucky, 33.5 percent of children age 10-17 are overweight or obese, compared to 31.2 percent nationwide. A diet high in sodium is strongly associated with obesity.

Agriculture Secretary Sonny Perdue has criticized the sodium restrictions, saying that children won't eat the healthier meals and that food gets thrown away.

The USDA's Food and Nutrition Service is also keeping in place a program that allows school districts to opt out of a requirement to supply whole grains in lunches, if the schools feel they can't procure enough whole-grain products.

School lunch rules relaxed: USDA delays lower salt limit, allows 1% milk, lets states exempt schools from whole-grain rule

Lunch at school in Henderson (The Gleaner photo)

Schools won't have to cut salt until 2020, and can serve 1 percent fat milk instead of nonfat milk, and states can allow some schools to serve fewer whole grains, under relaxed nutrition guidelines announced May 1 by U.S. Agriculture Secretary Sonny Perdue.

The announcement reversed the standards championed by former First Lady Michelle Obama in response to increasing obesity among children, but was welcomed by many school nutrition directors.

Mike Sallee, nutrition coordinator for Elizabethtown Inde­pendent Schools, told The News-Enterprise that he had been trying to figure out how to reduce the amount of sodium in meals to 935 milligrams from 1,230 mg, a “huge challenge” because food producers also would have to adjust to using lower amounts of sodium.

Josey Crew, nutrition director for Hardin County Schools, agreed. “It was kind of getting ridiculous with how they wanted to go,” she said, adding that the new rules might also help discourage food waste.

Crew and Sallee told the Elizabethtown newspaper's Katherine Knott that they are waiting for more guidance from the Kentucky Department of Agriculture on the changes. The new rules allow states to "grant exemptions to schools struggling to meet the whole-grain requirement for the 2017-18 school year," Knott writes. "Currently, all grains served must be whole-grain rich."

The National Parent Teacher Association said it was disappointed in the changes. “One in six adolescents is obese, while one in five faces hunger on a daily basis,” President Laura Bay said in a news release. “Critical progress has been made to provide children with healthier foods in schools. It is important that we build on this progress and do not go backward.”

However, "The changes were supported by the School Nutrition Association, the national organization for school nutrition professionals," Knott notes. "They have lobbied for more flexibility since requirements went into place in 2012."

Crew told Knott that complying with the 100 percent whole-grain requirement initially was difficult, especially for pizza: “To find a whole grain crust that tastes good was hard.” However, food manufacturers adapted, and “Now it tastes good. They figured out a good way to make it.”

Though the regulations are being relaxed, they have been in place for several years and the new offerings are "more accepted by students," Knott reports. "For younger students, it’s all they know when it comes to school lunches, Crew said."

More students eat lunch and breakfast at schools where number of 'food vulnerable' students qualifies all for free meals

Students eat breakfast (U.S. Department of Agriculture photo)

By Melissa Patrick
Kentucky Health News

A program that offers free meals to all students using federal money has increased lunch and breakfast participation at many schools in Kentucky, but may come under renewed threat in Congress.

The Community Eligibility Program, part of the 2010 Hunger-Free Kids Act, allows schools with more than 40 percent of students qualifying as "food-vulnerable" to offer free meals to every student.

The latest schools to report that the program has more students eating breakfast and lunch are Glasgow High School and the Berea Independent Schools.

Glasgow has seen a 5 percent increase in lunch participation and a 13 percent increase in breakfast participation since December 2015, Jackson French reports for the Bowling Green Daily News.

Before the school joined the Community Eligibility Program, it would provide meals to any student who wanted them even if they couldn't pay on that day, but would place a charge for the meal on the student's account to be paid later.

Principal Keith Hale told French that the program reduces financial burdens on families who struggle to pay for food and also allows students to eat healthier, because healthier foods are often costlier.

This is also the first school year that the Berea schools have participated in the program, Ricki Barker reports for the Richmond Register.

“We are serving approximately 60 more breakfasts and 80 more lunches a day compared to last year,” Supt. Mike Hogg told board members at their January meeting. He added that the school is serving about 1,000 more additional meals to students than they have in the past.

“If you are hungry, then you are not at your optimal learning potential,” Hogg said. “With the program we can feed more students and we know that those students are fed and ready to learn each day.”

This program is one that could be altered in the new Congress by Republicans who have long had issues with the 2010 law, the centerpiece of Michelle Obama's eight years as first lady.

Kentucky Health News reported in May that House Republicans had introduced a bill to raise the program's qualifying threshold to 60 percent. The bill passed out of committee but died for lack of action.

According to the liberal-leaning Center on Budget and Policy Priorities, the change could affect more than 350 Kentucky schools, because only 441 of the 804 schools currently eligible for the program would qualify under the 60 percent guideline.

Kentucky ranks 48th among states in percentage of kids getting summer meals from schools, but participation grew last year

Fewer than 8 percent of the Kentucky children who qualify for a summer meal program got such meals last summer, despite the availability of federal funds for it, according to a report from the Food Research & Action Center.

The report says that for every 1,000 children who ate school lunch during the regular school year, only 77 low-income children in Kentucky ate summer meals last year, based on average daily participation. That was 48th among the states, beating only Mississippi and last-place Oklahoma.

However, among the low-performing states, Kentucky was the only one to improve last year, based on figures for July, the middle month of the program. It served 10.3 percent more children and was one of 29 states to improve, the report said.

The report said the average daily participation in Kentucky last year was 25,437, compared to 23,057 in 2014.

“It’s very positive news that summer meals have been reaching more children,” Tamara Sandberg of the Kentucky Association of Food Banks said in a news release. “Kentucky can build on this progress by redoubling outreach efforts throughout this summer to make sure that children — and their parents — are aware of this valuable program. The summer nutrition programs can make a huge difference for the hundreds of thousands of children in our state whose families struggle to afford enough food.”

More school districts took part in the program last year than the year before. "The state had 149 sponsors in 2015 (up 8.8 percent from 2014) and 1,812 sites (up 69 percent)," reports Jonathan Greene of The Richmond Register.

In Madison County, schools have about 21 locations, and Berea College and Grow Appalachia have a five-location program for Berea children. “We have a lot of students in need,” County Schools Food Service Director Scott Anderson told the Register. “We see a lot of kids coming to school hungry. A lot of students tell us that this (school lunch) might be their only meal.”

Mike Sullivan, who manages the program for the Kentucky Department of Education, said, “Just as learning doesn’t end when the school year ends, neither does a child’s need for good nutrition. Without the Summer Food Service Program and the wonderful sponsors, thousands of children would not get the nutrition they need during the summer months. The development of these children depends in large part on making sure they get nutritious meals all year long.”

For a PDF of the report, click here.

Clinton County coalition works to change the health lifestyle of its children, in an effort to change the local health culture

By Melissa Patrick

Kentucky Health News

Public officials and local leaders in a small, rural county in Southern Kentucky that ranks near the bottom of in the County Health Rankings for the state have formed a coalition to improve the health of its community, with a focus on its children.

Clinton County (Wikipedia map)

Clinton County ranked 102nd out of 120 Kentucky counties in the 2016 County Health Rankings. “We recognize that. We saw that in our kids,” Lora Brewington, chief compliance officer of Cumberland Family Medical Center Inc., told Kentucky Educational Television in a report to be aired soon about the coalition.“And if we don’t change something now, we’re going to be going to the funeral home for kids a lot younger.”

So, with the help of the Foundation for a Healthy Kentucky, they formed the Clinton County Healthy Hometown Coalition to implement a multi-faceted public health program for the community's citizens, that focuses on its children.

“The coalition came together [according to] Aristotle’s thinking, that the whole is greater than the sum of its parts,” Brewington told KET. “We have a lot of great groups, that do a lot of great things, but if everyone is going for the same goal, and the resources are not combined, you’re not going to accomplish anything. And once we get everybody together and on the same page, by combining resources, we’ve been able to do some great things.”

Paula Little, assistant superintendent and supervisor of instruction for Clinton County schools, told KET that the coalition recognized most of the county's health issues stemmed from obesity, and decided to focus their efforts on the children in the community to change their culture.

"So we feel like if we can start young and start with our children and teach them healthy habits and healthy lifestyles that when they grow up they won't be faced with obesity and all of those chronic diseases that go with it," Little said.

Many of the coalition’s activities are school-based. Teachers have incorporated physical activity into the school day as well as during their morning routines and after-school day-care programs.

The coalition has worked with the schools to improve nutrition. Fruits and vegetables are now served every day with every meal. The schools also began offering supper to students during the school year and has since served over 6,400 meals. The program began last October.

Recognizing that an estimated 38 percent of Clinton County's children live in low-income families, the coalition launched a summer food program that delivers breakfast and lunch in a retrofitted school bus called the Bus Stop Café to areas in the county with high student populations.

The Healthy Hometown Coalition has also implemented school-based health clinics, which provides for the healthcare needs of students through a public-private partnership while they are at school. The clinics are run by the Cumberland Family Medical Center. In addition to providing clinical care, the clinics provide body mass index assessments and provide nutrition and obesity counseling.

“It’s about accessibility,” Brewington said. “It’s about the kid who has a cough and needs to see a doctor, but the parent can’t take off from work. ...It's about having healthcare right there where the child is the majority of the time."

Not mentioned in the KET report is that Clinton County schools implemented a comprehensive smoke-free policy last year that will go into effect in July. The policy will ban smoking on school property both during school hours and during school sponsored events, and also includes electronic cigarettes and all vapor products.

The coalition is working to change the culture of its community so that a healthy lifestyle becomes the norm, and not the exception.

“When you’re attempting to change a culture, and change the way people live, that’s a very long process,” Little said. “And it has to be something that’s consistent, that’s ongoing, and it has to be a message that children hear everywhere they go in the community.”

A full-time coordinator, April Speck, manages the various coalition programs and writes a weekly health column in the Clinton County News that often celebrates individual success stories. The coalition also sponsors community events, and has built a new playground.

“What makes me feel good about it is that I know there’s a real need here,” Speck told KET. “There’s a lot of kids who have childhood obesity... And just seeing them start to make changes in what they are doing, how much they are eating, their water intake, I know that we’re making an improvement.”

Slicing your way to an apple a day: Americans' apple consumption is on the rise because we're eating them in small pieces

Photo from livestrong.com

By Danielle Ray
Kentucky Health News

Presentation is everything. Apple consumption is on the rise, and researchers at Cornell University think pre-sliced apples are the cause.

The 2013 Cornell study explored why so many whole apples served in school lunches ended up uneaten in the trash. Researchers found that eating whole apples can be difficult for young children with small mouths and for kids with missing teeth or braces. The study also noted that older girls find whole fruits messy and unattractive to eat.

The study found that consumption jumped by more than 60 percent when apples were served sliced. These findings back up U.S. Department of Agriculture statistical data about overall apple consumption. Data show that Americans ate more than 510 million pre-sliced apples in 2014, up from fewer than 150 a decade before.

Likewise, overall apple consumption has grown by 13 percent percent since 2010, according to USDA data. Americans ate about 17.5 pounds per capita in 2013, the most in nearly a decade.

Why does simply slicing an apple matter? The difference between a whole apple and apple slices may seem silly or superficial, especially to an adult, but the inconvenience is a barrier nonetheless, David Just, a professor of behavioral economics at Cornell and one of the researchers behind the study, told Roberto Ferdman of The Washington Post.

"It sounds simplistic, but even the simplest forms of inconvenience affect consumption," Just said. "Sliced apples just make a lot more sense for kids."

The rise of mass-produced pre-sliced apples probably has a lot to do with the fast food industry. McDonald's added apple slices to its menu in 2004 in an effort to give parents healthier options. The company began automatically serving apple slices with Happy Meals in 2012, causing apple sales to skyrocket.

McDonald's has served more than 2 billion packages since first offering apple slices as a side, a representative for the company told the Post. In 2015 alone, the company served nearly 250 million packages of sliced apples, which amounts to more than 60 million apples, or about 10 percent of all fresh sliced apples sold in the United States, the Post noted.

The USDA, which oversees school lunch programs, can't be sure of how many schools offer pre-sliced apples versus whole apples, as local school districts make that decision. However, the agency does make recommendations and encourages schools make fruit appealing in presentation.

The problem with the pre-sliced apple trend? It may lessen food waste, but it increases plastic waste, which puts a strain on the environment. McDonald's apple slices, for example, are served in plastic wrappers. These wrappers are recyclable, yes, but two important differentials exist. First, "recyclable" does not mean it was made of recycled materials, only that it has the potential to be recycled. Second, just because consumers can recycle the wrappers does not mean they will.

House Republicans want to make it harder for schools to get free meals for all students; could affect more than 350 Ky. schools

Photo from npr.org

By Danielle Ray
Kentucky Health News

Kentucky school officials are concerned about a proposal by Republicans in the U.S. House that would make it harder for schools to offer free meals to all students using federal money.

The House is considering changes to the 2010 Hunger-Free Kids Act, now in its second year, which allows schools who serve a high-poverty population to offer free meals to every student.

Instead of collecting individual applications for free or reduced-price meals, the Community Eligibility Provision uses data that illustrates how many students in a given school may be "food-vulnerable": how many students live in households that receive government assistance, live in foster care, are homeless, and other similar criteria.

Under current CEP rules, schools with greater than 40 percent of students who qualify as food-vulnerable are eligible to offer free meals to all students. A bill approved May 18 by the House Education and Workforce Committee would raise the threshold to 60 percent, forcing schools between 40 and 59 percent range off the program.

"Proponents of community eligibility say it spares schools from paperwork and administrative burdens, and that it allows low-income children to eat free meals without the stigma or red tape of particpation in the free meal program, which is often a barrier for participation," Evie Blad reports for Education Week. "But Republicans on the committee said the provision is wasteful, potentially allowing children from higher-income families access to free meals."

The change could affect more than 350 Kentucky schools. Kentucky has 804 schools eligible to offer free meals under current CEP rules, according to the Center on Budget and Policy Priorities. Under the proposed bill, only 441 would qualify, according to the center.

More than 10,000 students at 17 public schools in Lexington alone would be affected, according to the Lexington Herald-Leader reported. More than 190,000 students statewide could be affected, the Herald-Leader said.

Nick Brake, superintendent of Owensboro schools, told Keith Lawrence of The Messenger-Inquirer that he is hopeful that his district will be spared cuts.

"I have been working with Congressman (Brett) Guthrie’s office on this issue," Brake said. "We are still looking at the overall numbers, but our district average is 63 percent, so it looks favorable that we will be able to continue to provide the benefit of this vital program in the future."

Muhlenberg County Supt. Randy McCarty told Lawrence he thought his district would still qualify. "Once a district goes CEP, it stays in place for four years," he said.

Hopkins County, which recently expanded its use of free meals to all public schools, faces uncertainty if the changes are passed.

"I have no idea if school districts will be grandfathered in, or how Congress will write everything, but I am afraid that if we don't jump on this now, we may not get this opportunity again," Michael Dodridge, food services director of Hopkins County schools, told Laura Buchanan of The Messenger in Madisonville. "I would hate to pass this up."

UPDATE, May 26: The Harlan Independent School Board voted to join the program, Joe Asher reports for the Harlan Daily Enterprise.

The proposed CEP changes are part of House Resolution 5003, the child nutrition reauthorization bill introduced by Indiana Republican Rep. Todd Rokita. For more information on the proposed changes, click here.

Childhood obesity rates continue to rise nationally while Ky.'s rate has leveled off, but 1/3 of kids are still overweight or obese

By Melissa Patrick
Kentucky Health News

Nationally, childhood obesity rates are not declining and severe obesity rates are still rising, especially among minority children. However, in Kentucky, child obesity rates have remained stable and the rates of obesity for minority children are not rising.

“Understanding the ongoing trends in obesity is important for public health and policymakers,” lead researcher Asheley Skinner, who is with the Duke Clinical Research Institute, said in a news release. “Our study suggests that more than 4.5 million children and adolescents in the U.S. have severe obesity."

The study, published in the journal Obesity, examined data from the National Health and Nutrition Examination Survey between 1999 and 2014 and found that 33.4 percent of children in the U.S. were overweight, meaning their body mass index (BMI) was above the 85th percentile for children their age. BMI levels estimate body fat based on height and weight.

In 2013-14, the study found that nearly 24 percent were obese, or above the 95th percentile, and that 2.4 percent were severely obese, or more than 140 percent of the 95th percentile.

The authors noted that the only statistical increase in child obesity since 2011 was found in those who were severely obese, which went up 2.1 percent, and this increase was most prevalent among African American and Latino children. The report also said that while there has been an increase in obesity in all age groups over the past 30 years, it "may be leveling off."

It could be that this "leveling off" effect is happening in Kentucky, where more than one-third of children are either overweight or obese.

The State of Obesity report found that 18 percent of Kentucky's high school students are obese, almost 20 percent of its 10- to 17- year olds are obese and 15.5 percent of its 2- to 4- year-olds from low-income families are obese. The report also shows that these rates have remained consistent for high school obesity since 2003, 10- to 17- year-olds since 2004 and the 2- to 4- year-olds since 2003.

The Kentucky Youth Risk Behavioral Survey also shows no overall statistical changes in obesity rates among  Kentucky's high-school students, including the state's African American high school students, whose rates range from from 15.5 percent obese in 2005 to 19.1 percent in 2013, or its Hispanic high school students, whose obesity rates were 15.5 percent in 2007 and 18.8 percent in 2013, the only two years with available data.

These reports did not break down the different levels of obesity.

Studies have shown that children with severe obesity are at an increased risk for heart disease, Type 2 Diabetes and even cancer when compared to children who are only considered overweight or mildly obese, says the release.

Skinner said it is time to expand local interventions and to find new treatment approaches.

"Addressing obesity in children is going to require a true population health approach, combining efforts at individual, healthcare, community and policy levels," she said in the release.

What is Kentucky doing about childhood obesity?

Kentucky's schools, as community partners in the battle against childhood obesity, are working to combat it through both nutrition and movement initiatives.

For example, most public Kentucky schools participate in the 2010 Healthy, Hunger-Free Kids Act that requires schools to provide healthier foods for their students; many schools participate in the Fresh Fruit and Vegetable Program, which provides a daily fruit or vegetable snacks to every student in participating schools; and more than 80 Kentucky school districts participate in the National Farm-to-School program.

Jamie Sparks, the school health and physical education director for the Kentucky Department of Education, said in an e-mail to Kentucky Health News that Kentucky schools are working to get students more active through several initiatives.

Sparks pointed out several successes, including school partnerships with the Alliance for a Healthier Generation initiative; a partnership with Humana Vitality called Students with Active Role Models, which encourages teachers and school staff to earn Vitality points by leading physical activity with their students; and partnerships with an online program called GoNoodle, which increases physical activity time in the classroom.

In addition, Sparks said, "Kentucky ranks second in the percentage of public schools enrolled with Let’s Move Active Schools. We have hosted 10 Physical Activity Leader trainings in the past three years."

But is that enough to make a difference?

Dr. Willian Dietz, author of an accompanying journal editorial, said there is a shortage of care-givers to treat obesity, noting that every primary care provider who takes care of children is likely to have about 50 pediatric patients with severe obesity in their practice. He also said that most of these providers aren't trained to treat childhood obesity, nor are they compensated appropriately, if at all, to treat it.

"We need more effective, cost-efficient and standardized approaches and services to manage children with the most severe obesity. This research emphasizes the urgency with which we must develop and validate a reimbursable standard of care for severe obesity in children and adolescents,"Elsie Taveras, spokesperson for The Obesity Society, said in the release.

It should be noted that Dietz, who is the director of the Global Center for Prevention and Wellness at George Washington University, said in his editorial that other data shows obesity rates have declined in two- to five- year olds. He said that this doesn't mean this study is incorrect because different time frames were used. "It all depends on how you look at it," he said. He did, however, acknowledge that severe obesity is increasing among adolescents.

He said, “The authors’ observation that severe obesity has increased is of great concern, especially because children with severe obesity become adults with severe obesity.”

Visiting chef at Harlan County High helps incorporate fresh, local foods and flavors into menus; 1 of 8 Ky. districts in program

image: foodtank.com

The "Chefs in Schools Collaborative" project, which helps school cooks learn how to incorporate fresh, local foods in their menus, is up and running at Harlan County High School, reports WYMT-TV.

"Fresh ingredients are always important to a cook," Judy Gurnee, visiting chef through March, told the Hazard station. "We like to work with the closest available products that we can get ... the finest quality."

Harlan County is one of eight Kentucky school districts in the program. Its cooks asked the visiting chef to help them better use spices on the local vegetables, so that students, whom they described as their "customers," would eat them.

"I'm for anything that's going to get the children to eat," Kitchen Manager Jan Hicks told WYMT. "That's what we are here for."

Making sure the kids eat their school lunch is especially important because for some, it is the only meal they get a day, WYMT reports.

"Our kids, one in four are homeless," Director of Food Service Jack Miniard said. "That means that they are living with a grandparent or they are living with some other family member ... so, this may be the only meal that they get a day."

The program is led by the Kentucky Department of Agriculture's Farm to School Program in partnership with the Community Farm Alliance and the National Farm to School Network. Participating school districts are in Boyle, Clark, Grayson, Oldham, Harlan, Martin, Morgan, and Pike counties.

About 60% of Ky. schools give all students free breakfast and lunch; federal program for those with mainly low-income students

photo: Kentucky Department of Education

During the 2014-15 school year, 104 of the 173 public school districts in Kentucky provided free breakfast and lunch to all students, with 610 schools and 279,263 children benefiting in the program, according to the U.S. Department of Agriculture website.

They were able to do this through the Community Eligibility Provision program, which allows school districts with predominantly low-income children to serve all students free lunch and breakfast. Kentucky was one of the first three states chosen to participate in the pilot program in 2011-12, which is now available nationwide. CEP is part of the Healthy, Hunger-Free Kids Act of 2010.

"Schools implementing CEP have reported great success, citing eased administrative burden, more efficient meal service operations, and increased program participation," Angela Kline, director of USDA policy and program development, said in an online letter to the regional and state directors of the program. "Most importantly, students attending CEP schools can count on two nutritious meals every school day, helping low-income families to stretch limited food budgets while reducing hunger among our nation’s children."

This is the first year the East Bernstadt Independent school district in Laurel County has participated in the program. Marcella Hensley, the food service director, called the program a success and said they plan to apply for the program again next year, Mike Moore reports for The Sentinel-Echo in London.

The northern Laurel County district has 462 students in K-8, plus 55 preschool students, Moore reports. Since the program began at the start of the school year, Hensley told Moore that she has seen a 2-percent increase of breakfasts and lunches being served, adding that the cafeteria staff prepares 980 breakfasts and 2,064 lunches per week. She said this amounts to about 70 to 80 more students at lunch each day and 80 to 90 more students at breakfast, compared to previous years.

 “I feel that if a child eats a breakfast, they function better in class,” Hensley told Moore. “They’re more alert and ready for what they’ve got coming at them academically-wise. To me, breakfast is more important because they function better during the day. If we see their faces more at breakfast, I feel like they’re going to do better in class.”

Chefs to show how to get fresh, healthy, local food in Boyle, Clark, Grayson, Harlan, Martin, Morgan, Oldham, Pike county schools

image: nkyhealth.org

Chefs will help eight Kentucky schools learn to incorporate fresh, local foods in their menus as part of a "Chefs in Schools Collaborative" pilot project, according to a news release from the Kentucky Department of Agriculture.

 "School food service workers want to serve healthy, delicious meals to Kentucky children, and these projects will help them do that," Agriculture Commissioner Ryan Quarles said in the release. "These investments will help the next generation of Kentuckians grow up healthy and strong, and they also will teach them to value farmers and local food systems as a way of life."

The project will educate food service employees on how to incorporate fresh, local foods into their menus, help them develop new recipes that include local foods and provide opportunities for local farmers to engage with the staff and students. 

The pilot program will run from February through May and is led by the Agriculture Department's Farm to School Program in partnership with the Community Farm Alliance and the National Farm to School Network. 

The National Farm to School Network will use a grant from Seed Change to support the program in Boyle, Clark, Grayson, and Oldham counties. The Community Farm Alliance will use funding from the Central Appalachian Network to support the program in Harlan, Martin, Morgan, and Pike counties.

Washington state study finds new school lunch standards have made students' food healthier; other studies say they are eating it

School lunches are healthier since the federal government created sweeping changes to the program five years ago and almost the same number of students eat a school lunch as before the changes were implemented three years ago, according to a study in Washington state, published in the journal JAMA Pediatrics.

The 2010 Healthy, Hunger-Free Kids Act requires schools to make their menus healthier with more whole grains, fruits and vegetables, less fat and sodium and smaller portion sizes. In 2014, the law added similar nutritional guidelines to all snacks and beverages served during the school day.

Researchers looked at the nutritional value of school lunches and the food choices of about 7,200 students in three middle schools and three high schools in an urban school district in Washington. Data was collected 16 months before and 15 months after the new nutrition standards were implemented for the 2012-13 school year.

The study found that the new rules did not significantly change how many students participated in the meal program. It did not look at whether the students actually ate their healthier lunch, but the researchers cited previous research that found the amount of plate waste has not changed since meal changes were introduced.

The rules have come with some growing pains and complaints from students and dietary staff about food waste, smaller portion sizes, changes in food preparations that make the food unappetizing, fewer students buying lunch and the added cost incurred to pay for the healthier foods.

These complaints prompted the School Nutrition Association and the School Superintendents Association to write a letter to Congress asking for some changes including increased reimbursement to cover the costs of the new meal standards and a request to decrease the whole grain requirements back to half, Carina Storrs reports for CNN.

137 Ky. schools chosen for Fresh Fruit and Vegetable Program; students at one Barren County school have embraced it

Park City Elementary School in Barren County is one of 137 Kentucky elementary schools selected this year to participate in a program that  provides a daily fruit or vegetable snack to every student in the school, Jeff Nations reports for the Glasgow Daily Times.

“Right now we’re doing a lot of fruits, more than vegetables because it seems like our fruits are fresher right now,” Angie Morgan, Park City cafeteria manager, told Nations.“We’re doing bananas, apples, grapes, strawberries, pears — they really like the bananas, they love the grapes.”

Schools chosen for the Fresh Fruit and Vegetable Program, implemented through the U.S. Department of Agriculture as part of the effort to combat childhood obesity, are required to participate in the National School Lunch Program and have 50 percent or more of their students eligible for free/reduced-price meals, according to a Kentucky Department of Education press release. The program requires a yearly application and Park City Elementary is already planning to re-apply. 

Kentucky received $2.95 million in FFVP funding for the 2015-`16 school year, which will provide a fresh fruit or vegetable snack to nearly 59,000 students in the 137 chosen Kentucky schools. Each participating school will receive approximately $50 per student to provide for this program, according to the news release. To see if your school was chosen for this program, click here. 

Teachers say the Park City Elementary students have embraced the daily snack program, but they also note that it offers students an opportunity to demonstrate leadership, connecting the daily responsibility of getting the healthy snack for the classroom to the school's "Leader in Me" initiative. 

“The teachers give the children jobs in their classroom, and (this program) gives a child a job,” Morgan told Nations. “They know that this week, it’s their responsibility to stop and pick up the fruit for the room.”

Teachers have flexibility in when to offer the snacks, with many of them at Park City Elementary incorporating it into daily reading time, Nations reports.

“It becomes almost like a home environment here at school, and they really see it as reading for enjoyment as opposed to reading for an assignment task,” Anthony Janes,  Park City's principal, told Nations. “If you look at data, if you read 20 minutes a day, then you can increase your vocabulary exponentially just by reading for enjoyment.”

Eventually, Park City Elementary plans to offer the students unfamiliar fruits and vegetables, which is one of the goals of the program..

 “Many of our students just aren’t exposed to those options, and to say that they’re going to get kiwi or they’re going to get starfruit, I’m really excited about that for the kids,” Janes told Nations. “It’s an opportunity.”

Students at this elementary school who don't want the snack are asked to place it on a sharing table in their given classroom and any fruits or vegetables not eaten at the end of the day are given to the Run Club for their after-school snack.

Nationally and statewide, farm-to-school program is a success

With approximately 80 Kentucky school districts participating in the Farm to School program, many of them are finding special ways to celebrate National Farm to School Month, with much to celebrate, as a preliminary U.S. Department of Agricuture report finds that schools that participate in Farm to School programs show an increase in the number of school meals sold, an increase in the consumption of healthier foods and decreases in plate waste.

“By investing in Farm to School not only will the next generation be healthier but they will be more informed consumers who value the farmer and support their local food system, not as a novelty but as a way of life," Tina Garland, procedures division coordinator for the Kentucky Farm to School program, said in a telephone interview.

The Jefferson County Public Schools are celebrating National Farm to School Month with its cafeterias serving a menu full of locally grown food at district elementary, middle and high schools on Oct. 23 and 24, Ja'nel Johnson reports for WFPL Radio.

JCPS began its farm-to-school initiative about eight years ago with apples from a farm in Indiana, but has since grown to include seven local farmers in Kentucky, Indiana, Ohio and Tennessee, Johnson reports.

The district's goal is for 10 percent of its produce to be locally grown, Dan Ellnor, manager of the Nutrition Service Center at JCPS, told Johnson, explaining that because they serve 112,000 meals a day, it is difficult to incorporate locally grown produce into every meal.

"Last year, 3 percent of the district’s produce came from local farmers, and JCPS spent $124,000 on local produce. So far this year, $131,000 has been spent on local foods," Johnson writes.

Ellnor told Johnson that this program helps teach students where their food comes from, which is part of the program's mission.

“There are kids, honestly, who don’t know that ketchup comes from a tomato,” he said.

More schools than ever are participating

Although the farm-to-school initiative has been around for many years, the national Farm to School Grant Program was created more recently through the Healthy, Hunger-Free Kids Act of 2010 to help eligible schools implement programs to improve their access to local foods. To date, the grant program has funded 221 farm to school projects, totaling $15.1 million, according to its website.

The Kentucky Department of Agriculture has been the recipient of a USDA Farm to School support service grants, which allowed them to re-grant 11, $5,000 mini-grants across the state to either help develop new farm-to-school programs or to enhance existing programs, according to Garland.

"Farm to school is one of many tactics and resources that USDA makes available to help schools successfully serve healthier meals to kids," Agriculture Secretary Tom Vilsack said in a news release. "Farm to school partnerships have a proven track record of encouraging kids to try, like and eat more healthy foods and creating new market opportunities for the farmers that grow them."

Preliminary results from from USDA's Farm to School census found that 17 percent of school districts that participate have reduced plate waste; 28 percent are more accepting of healthier school meals; 17 percent have increased participation in school meals; 21 percent have lowered the school meal program costs; and 39 percent have more support from parents and their community for healthier school meals.

The preliminary report also found that since the inception of the grant program two years ago, there has been a 55 percent increase in the local purchase of foods, to $598.4 million in 2013-14 from $385.8 million in 2011-12.

JCPS's goals of increasing its share of locally grown produce to 10 percent fits with the preliminary census findings that found almost half of its respondents said they planned to increase their local food purchases in the coming years.

Nationwide, more than 42,000 schools have farm-to-schools programs,according to the release.

According to the latest official data, in 2011-12 Kentucky schools spent $1.6 million on local foods, which involved 60 school districts and approximately 702 schools, according to Garland. To date, Garland said this number has increased to approximately 80 school districts and over 200 farmers participating in the Kentucky Farm to School program.

Kentucky was also one of three states to receive a National Farm to School Network Seed Change pilot grant, made possible through a generous donation from the Walmart Foundation, that allowed them to distribute 20, $5,000 mini-grants across the state to create or support Farm to School programs, according to Garland, noting that this is a different program than the Farm to School Grant Program.

Are your children's school foods canned or in plastic? That could cause health problems, study in California suggests

Researchers have found that elementary-school children, especially low-income students who are more likely to eat federally funded foods rather than pack a lunch, are being exposed to "school meals that may contain unsafe levels of bisphenol A (BPA), a chemical often found in canned goods and plastic packaging," Paige Miller reports for Stanford University, home to some of the researchers. "BPA can disrupt human hormones and has been linked to health effects ranging from cancer to reproductive issues."

The study was done in urban, suburban and rural schools in the San Francisco Bay area by Stanford's Prevention Research Center and the Johns Hopkins Bloomberg School of Public Health, and was published in the Journal of Exposure Science and Environmental Epidemiology.

Researcher Jennifer Hartle told Miller, "During school site visits, I was shocked to see that virtually everything in school meals came from a can or plastic packaging. Meat came frozen, pre-packaged, pre-cooked and pre-seasoned. Salads were pre-cut and pre-bagged. Corn, peaches and green beans came in cans. The only items not packaged in plastic were oranges, apples and bananas."

Researchers track BPA intake in terms of micrograms per kilogram of body weight per day. Rodents experience toxicity at 2 mcg/kg, but the toxic level for humans is unknown because it's also unknown how humans metabolize BPA, Miller writes. In 1988, the Environmental Protection Agency "defined safe BPA consumption levels as 50 micrograms or less per kilogram of body weight per day," Miller writes. "Since then, hundreds of scientific papers have found detrimental biological effects of BPA at levels lower than the EPA standard. The European Food Safety Authority recently updated its standards for safe BPA intake to 4 micrograms per kilogram of body weight per day."

The study found that a student consuming pizza and milk with canned fruits and vegetables could take in anywhere from minimal levels of BPA up to 1.19 mcg/kg each school day. "While most students would not consume the maximum amount, those who do would take in more than half of the dose shown to be toxic in animal studies in just one meal," Miller writes.

Study co-author Robert Lawrence of Johns Hopkins told Miller, "With endocrine-disrupting chemicals particularly, there is so much uncertainty. We can't tie a specific dose to a specific response like we can with lead. But we know BPA is impacting human health. Animal models are showing there can be a whole range of health effects. This research shows we should take a precautionary approach." (Read more)

Newspapers across the state are reporting about school lunch and nutrition programs, of great interest to readers with students

Kentucky newspapers are writing about school meals, against the backdrop of controversy about federal nutrition guidelines, and these are stories with a high level of interest among a key demographic - readers with children of school age.

The Glasgow Daily Times  recently reported that a new deli-style option at Barren County High School has more than doubled its sales of this grab-and-go option since it has been offered this year, compared to the old grab-and-go option that was pre-assembled and served in a bag. The article noted that this new option has been well-received by both the students and staff, all while staying within the new federal nutrition guidelines.

The Hickman County Gazette reported that the county schools have increased breakfast participation to 68 percent, up from 23 percent last year and lunch participation to 95 percent, compared to 77 percent the same time last year. (This story is behind a paywall.)

Schools Nutrition Director Lynsi Barnhill told the newspaper that the increase can be attributed to the nutrition staff working with the students through surveys to create a menu that they like, but still stays within the federal nutrition guidelines; and that the school district is now classified as a Community Eligibility Provision school district, which allows schools to offer breakfast and lunch at no cost to all of its students.

The Independent in Ashland reported on a campaign, called "No Soda September,"  to encourage families in Boyd and Greenup counties to drink more water and less sugary beverages throughout the month. This effort is a partnership between The Appalachian Partnership for Positive Living and Eating and the local Boyd and Greenup counties middle and elementary schools.

"Classes that returned signed pledges received free color-changing water bottles and water trackers for students and teachers. More than 2,300 water bottles have been distributed," Adam Black writes.
  .

This idea was spurred by the health department's 5-2-1-0 APPLE program, which is funded by a grant from the AstraZeneca HeathCare Foundation’s Connections for Cardiovascular Health, that suggest kids get: • 5 servings of fruit or vegetables • 2 hours or less of screen time • 1 hour of physical activity • 0 sugar-added beverages. 

"The consumption of sugary beverages, especially among young children who drink more than one beverage a day, leads to a higher risk of being overweight or obese and children with obesity issues are more likely to suffer from health problems such as asthma, headaches, depression and type 2 diabetes," according to the health department, Black reports.

"Officials also report the consumption of sugary beverages can lead to many dental issues, including cavities that can cause pain, infection, tooth loss and in severe cases, death," he writes.

The News-Graphic in Georgetown reported on how several schools  in Scott County, like many across the state, are conducting food drives to support its "Send Out Snacks Backpack" program to make sure kids don't go hungry over the weekend.

Becky McDonald, the family resources coordinator at Garth and Eastern elementary schools told Kayla Pickrell of the News-Graphic that the backpack program helps children who are on free or reduced lunch have food over the weekend by giving them backpacks with enough easy to prepare breakfast, lunch and snack foods to last until they come back to school on Monday. 

 “We have families who struggle to feed their kids over the weekend” because they are used to the free or reduced lunch during the week, McDonald said. “It helps out the parents a lot.” (This story is behind a paywall.)

New deli-style healthy food choices are a huge success at Barren County High School; meet federal nutrition guidelines too

BCHS Director of Nutrition Services
CheyAnne Fant and Assistant Nutrition
Services Manager Danielle Certain at the
high school's new Fresh Market 95210
(Daily Times photo by Jeff Nations)

Students and staff at Barren County High School have embraced the school's new healthier "grab and go" option that looks and feels like a deli, Jeff Nations reports for the Glasgow Daily Times.

“Part of our strategic plan for nutrition services was to create areas that made you feel like you were in like, small shops or different venues that those students could go to,” CheyAnne Fant, Barren County’s director of nutrition services, told Nations. “And the second purpose of that was to decrease the time that the students were in line so that they’d have more time to eat.”

This new option offers deli-style sandwiches, fresh salads, fruits and vegetables, chips and smoothies and is called "Fresh Market 95210," which represents a district-wide wellness policy that says students should get: • 9 hours of sleep • 5 servings of fruit or vegetables • 2 hours or less of screen time • 1 hour of physical activity • 0 sugar-added beverages.

The school offered a "grab and go" option in the past, but the meal components were pre-assembled and served in a bag. Students and staff can now create their own grab-and-go lunch with some stipulations, in accordance to the National School Lunch Program’s requirements for reimbursement to the school, Nations reports.

"For example, at Fresh Market 95210 if a student chose a sandwich, they would have their choice of any fruit or vegetable and any other side item. If they select a salad (chef or vegetarian), their required fruit/vegetable serving is met and they can choose any other two sides," he writes.

Fant told Nations that the school has more than doubled its grab-and go meal sales since Fresh Market 95210 opened seven days after school began, going from about 31 a day in the first seven days of school to 67 a day, also noting that 24 percent of adult sales have since come from the Fresh Market.

Victoria Smith, a senior at BCHS, told Nations why she liked the Fresh Market: “There’s more time to sit down and talk. It’s quicker, there’s not as many people over there, and it’s healthy.”

“One of the things I think is exciting about this next generation of kids coming through that I think about is that they’re already going to have those healthy habits developed,” Shelly Young, the school’s central kitchen assistant manager, told Nations. “It’s going to be exciting to see it, but what’s really good is those things are already established so we’re going to have a whole generation of kids who are growing up healthier.”

Boone County Schools strategically implement healthy changes to lunch menu

Boone County Schools began serving healthier food and offering low-fat, low-sodium meals in their lunchrooms before the Healthy, Hunger-Free Kids Act was implemented in 2010, Amy Scalf reports for the Community Press.

"Whole grain is our largest issue," Food Service Director Barbara Kincaid told the weekly paper published by The Cincinnati Enquirer. "We work really hard on that because some students find these products unacceptable. . . . Sometimes we don't point out that items are whole-grain, but they are."

Dr. Randy Poe, superintendent, said nutrition education is important in the school environment: "A healthy child can make healthier choices, which leads to improved academic performance. So, it's beneficial to not only make sure our students are eating healthy but to make sure they understand the importance of eating healthy and how it affects their brain, body functions and growth."

Kincaid said introducing new foods is a little easier with younger students, and "adding unusual vegetables as a garnish can generate interest among students," Scalf reports. "The students get used to seeing them and begin to try them," Kincaid said. "Kids who say they don't like tomatoes may try them if they're offered as a garnish." They have been careful to make a few changes at a time. Boone County school cafeterias no longer serve foods with trans fats and high-fructose corn syrup.

"Nationwide, there's a 15 percent reduction of kids eating school lunches," Kincaid said. "In the past four years, there has been a 7 percent reduction in Boone schools. That's significant, and it's still troublesome to me because those are kids we're not feeding, and I want to feed all of them."